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Individual
LARRY DALE HISEL
Active
Individual
LARRY DALE HISEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
8690
TX
1041C0700X
Clinical Social Worker
Primary
27228
TX
Other
Enumeration date
06/13/2017
Last updated
07/21/2022
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